川崎病患儿血浆IL-12p40水平测定及意义

目的观察川崎病(KD)患儿血浆白细胞介素(IL)12亚基p40水平的变化,探讨血浆IL-12p40水平与KD患儿冠状动脉损伤(CAIs)及静脉注射免疫球蛋白(IVIG)治疗敏感性的关系。方法 62例KD患儿根据冠状动脉损伤情况分为CAIs组与非CAIs组,根据IVIG治疗效果分为IVIG敏感组与IVIG不敏感组。采用双抗体夹心酶联免疫吸附试验(ELISA)测定KD患儿IVIG治疗前后及33例健康儿童血浆IL-12p40水平,同时采用速率散射比浊法和溴甲酚绿法分别测定KD患儿急性期血浆C反应蛋白(CRP)、白蛋白(Alb)水平。结果 KD患儿急性期IL-12p40水平(pg/ml)(M=689.5,P5=263.5,P95=2261.4)高于正常对照组(M=632.2,P5=226.7,P95=1829.3),经检验差异有统计学意义(Z=2.821,P0.01),CAIs组血浆IL-12p40水平(pg/ml)(M=716.2,P5=282.4,P95=2464.1)高于非CAIs组(M=664.1,P5=246.4,P95=1997.3),差异有统计学意义(Z=2.565,P0.01)。KD患儿急性期血浆IL-12p40水平与CRP水平(mg/L)呈显著正相关(r=0.472,P0.01),与白蛋白水平(g/L)呈显著负相关(r=-0.421,P0.01)。IVIG治疗前IVIG敏感组与不敏感组之间血浆IL-12p40水平差异无统计学意义(Z=1.523,P0.05),但IVIG治疗后敏感组血浆IL-12p40水平明显下降,与治疗前比较差异有统计学意义(Z=2.637,P0.01),而IVIG不敏感组治疗前后血浆IL-12p40水平差异无统计学意义(Z=1.685,P0.05)。结论 IL-12可能参与了KD的免疫损伤过程,血浆IL-12p40水平变化在一定程度上可反应疾病的严重程度,并对预测是否并发冠状动脉病变及IVIG治疗效果评价有一定价值。

Detection of plasma IL-12p40 level in infants with Kawasaki disease and its significance

Objective To investigate the changes of plasma IL-12p40 level in infants w ith Kaw asaki disease（ KD）and the relationships betw een plasma IL-12p40 level and coronary artery injury（ CAI） and betw een plasma IL-12p40 level and sensitivity to intravenous immunoglobulin treatment. Methods ELISA-sandw ich technique w as used to detect the plasma IL-12p40 levels of 62 KD infants before and after IVIG treatment and the plasma IL-12p40 levels of 33 healthy controls. C reactive protein（ CRP） and Albumin（ Alb） level in plasma of KD infants w ere also detected.Results The plasma IL-12p40 level in KD infants（ pg / ml）（ M = 689. 5,P5 = 263. 5,P95 = 2261. 4） w as higher than that in healthy controls（ M = 632. 2,P5 = 226. 7,P95 = 1829. 3）,and significant difference existed betw een the tw o groups（ Z = 2. 821,P〈0. 01）. The plasma IL-12p40 level in the KD infants w ith CAIs（ M = 716. 2,P5 = 282. 4,P95 = 2464. 1） w as higher than that in the KD infants w ithout CAIs（ M = 664. 1,P5 = 246. 4,P95 = 1997. 3）,and significant difference existed betw een the tw o groups（ Z = 2. 565,P〈0. 01）. The level of plasma IL-12p40 in KD infants w as positively correlated w ith CRP level（ mg / L） in plasma（ r = 0. 472,P〈0. 01） and negatively correlated w ith Alb level（ g / L）（ r =-0. 421,P〈0. 01）. No significant difference in plasma IL-12p40 level before IVIG treatment w as found betw een KD infants w ho w ere sensitive to the treatment and KD infants w ho w ere not sensitive to the treatment（ Z = 1. 523,P〈0. 05）,but in KD infants w ho w ere sensitive to IVIG treatment,the plasma IL-12p40 level significantly decreased after the treatment（ Z = 2. 637,P〈0. 01）. How ever,there w as no significant decline of plasma IL-12p40 level in the KD infants w ho w ere not sensitive to IVIG treatment（ Z = 1. 685,P〈0. 05）. Conclusion IL-12 may participate in the immune damage caused by KD,and the changes of IL-12p40 level in KD infants may reflect the severity of illness,and can